Claims Representative - Remote

Remote, USA Full-time Posted 2025-02-21

## Job Overview
We are seeking a detail-oriented Claims Representative to join our team. The ideal call center agent be responsible for processing and managing medical claims, ensuring accuracy and efficiency in claims resolution.

## Duties

  • inbound outbound call support.
  • good understanding of Microsoft excel.
  • Review and process health insurance claims for accuracy and completeness
  • Utilize financial software to assess and calculate claim amounts
  • Understand and apply ICD-9 coding to claims
  • Maintain medical records and documentation related to claims
  • Familiarity with Workers' Compensation laws and regulations
  • Verify insurance coverage and eligibility for claimants
  • Knowledge of medical terminology to accurately assess claims
  • Collaborate with medical billing teams for claim processing
  • Ensure proper insurance verification procedures are followed
    ## Requirements
  • Previous experience in clerical roles within the insurance or healthcare industry is preferred
  • Proficiency in financial software for claims processing.
  • proficient in Microsoft excel.
  • good call center experience.
  • Knowledge of Workers' Compensation laws is a plus
  • Strong attention to detail and accuracy in claim assessment
  • Excellent communication skills for interacting with claimants and internal teams

Job Type: Full-time

Pay: $54,007.00 - $58,516.00 per year

Benefits:
? Work from home

Schedule:
? 8 hour shift
? Monday to Friday

Education:
? High school or equivalent (Preferred)

Experience:
? Microsoft Office: 1 year (Preferred)
? Customer service: 1 year (Preferred)
? Call center: 1 year (Preferred)
? MEDICAL/HEALTHCARE CLAIMS: 1 year (Preferred)
? Microsoft Excel: 1 year (Preferred)
? INBOUND / OUTBOUND CALL: 1 year (Preferred)

Work Location: Remote

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